Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding

Nadler, Evan P.; Youn, Heekoung; Ginsburg, Howard B.; Ren, Christine; Fielding, George

doi:10.1016/j.jpedsurg.2006.09.014

Cited by 76 publications

(43 citation statements)

References 20 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our meta-analysis, 8 of 21 cases were adolescents, and 6 of 21 were younger than 25 years at the time of bariatric surgery. Little is known about long-term outcomes in adolescents treated with bariatric surgery because as yet only a few studies are available (42)(43)(44). Two years after LAGB, O'Brien et al (45) have shown a mean weight loss of 34.6 kg in 25 adolescents, which represents 23.8% of variation in weight.…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Bretault

Boillot

Muzard

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

Objectives: Craniopharyngiomas are rare low-grade tumors located in the hypothalamic and/or pituitary region. Hypothalamic involvement and treatment resulting in hypothalamic damage are known to lead to development of "hypothalamic obesity" (HyOb) in 50% of cases. The management of HyOb, associated with eating disorders and rapid comorbidities, is an important issue. Bariatric surgery is the most effective therapy for weight loss in patients with severe exogenous obesity. The aim of this systematic review and meta-analysis was to determine the 12-month outcome of bariatric surgery for HyOb due to craniopharyngioma treatment. Methods and Results:Relevant studies were identified by searches of the MEDLINE and EMBASE databases until January 2013. A total of 21 cases were included: 6 with adjustable gastric banding, 8 with sleeve gastrectomy, 6 with Roux-en-Y gastric bypass, and 1 with biliopancreatic diversion. After data pooling, mean weight difference was Ϫ20.9 kg after 6 months (95% confidence interval [CI], Ϫ35.4, Ϫ6.3) and Ϫ15.1 kg after 12 months (95% CI, Ϫ31.7, ϩ1.4). The maximal mean weight loss was achieved by the gastric bypass group: Ϫ31.0 kg (95% CI, Ϫ77.5, ϩ15.5) and Ϫ33.7 kg (95% CI, Ϫ80.7, ϩ13.3) after 6 and 12 months, respectively. Conclusions:In this largest ever published study on the effect of bariatric surgery on obesity after craniopharyngioma treatment, we observed an important weight loss after 1 year of follow-up. Larger studies are warranted to establish appropriate selection criteria and the best surgical technique to perform bariatric surgery. (J Clin Endocrinol Metab 98: 2239 -2246, 2013) C raniopharyngiomas are benign, slow-growing tumors that are located within the sellar and parasellar region of the central nervous system. There are 2 histological types: the adamantinomatous tumors, mostly seen in children, which arise from epithelial remnants of the Rathke's pouch; and the squamous papillary form, seen in adults. The incidence rate ranges from 0.5 to 2 per million subjects/year, with a peak between 5 and 14 years of age, although craniopharyngiomas can occur at any age (1).Tumor resection, with or without radiotherapy, represents the therapeutic standard of care. After treatment, obesity and eating disorders are observed in 40 -50% of patients (2-4). Weight gain is also observed at diagnosis before treatment in some patients. Risk factors for the development of obesity after treatment of craniopharyngioma include younger age at diagnosis, presence of endocrinopathy whatever type, initial symptoms of intracranial hypertension, greater body mass index (BMI) at diagnosis, familial predisposition for obesity, and hypothalamic involvement. In addition, pterional surgery, multiple surgery, and hypothalamic irradiation with doses greater than 51 Gy have been associated with the development of obesity (3,(5)(6)(7).The cause of weight gain in this setting is incompletely understood, but it is believed to be due to "endogenous" mechanisms, rather than the more common form of "exogenous" obesit...

show abstract

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Bretault

Boillot

Muzard

et al. 2013

The Journal of Clinical Endocrinology &Amp; Metabolism

View full text Add to dashboard Cite

show abstract

“…In a small trial in patients with a BMI ranging from 30 to 35 surgical treatments using laparoscopic adjustable gastric banding were statistically significantly more effective than non-surgical therapy in reducing weight, resolving the metabolic syndrome, and improving quality of life during a 24-month treatment program (62). Thus, by taking comorbidities and other patient characteristics into account, it will be possible to better identify those who will benefit the most from bariatric surgery without using absolute age and/or BMI criteria (62,(115)(116)(117). Moreover, it should be noted that comorbid conditions caused by obesity are an argument in favor of bariatric surgery.…”

Section: Six Weeks Postoperativementioning

confidence: 99%

Surgical treatment of obesity

Bult¹,

Dalen²,

Müller³

2008

European Journal of Endocrinology

229

141

View full text Add to dashboard Cite

More than half of the European population are overweight (body mass index (BMI) O25 and !30 kg/m 2 ) and up to 30% are obese (BMIR30 kg/m 2 ). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic extent of overweight and obesity with its associated comorbidities has led to the development of therapies aimed at weight loss. The long-term effects of diet, exercise, and medical therapy on weight are relatively poor. With respect to durable weight reduction, bariatric surgery is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated complications. Recent evidence shows that bariatric surgery for severe obesity is associated with decreased overall mortality. However, serious complications can occur and therefore a careful selection of patients is of utmost importance. Bariatric surgery should at least be considered for all patients with a BMI of more than 40 kg/m 2 and for those with a BMI of more than 35 kg/m 2 with concomitant obesity-related conditions after failure of conventional treatment. The importance of weight loss and results of conventional treatment will be discussed first. Currently used operative treatments for obesity and their effectiveness and complications are described. Proposed criteria for bariatric surgery are given. Also, some attention is devoted to more basic insights that bariatric surgery has provided. Finally we deal with unsolved questions and future directions for research. European Journal of Endocrinology 158 135-145

show abstract

“…The overall excess weight loss after 1 year was 37% and slightly increased to 42% after 5 years. Various studies report excess weight loss at 6 months between 34 and 42% and between 30 and 63% after 1 year [8,15,20,21]. O’Brien et al [6 ]reported a gradual progression of weight loss in the first 3 years after LAGB which remained stable up to 8 years without a rebound effect, i.e.…”

Section: Discussionmentioning

confidence: 99%

Outcome of 232 Morbidly Obese Patients Treated with Laparoscopic Adjustable Gastric Banding between 1995–2003

et al. 2010

View full text Add to dashboard Cite

Background: Laparoscopic adjustable gastric banding (LAGB) is widely used for the treatment of morbidly obese patients. We prospectively evaluated the effect of LAGB since 1995. Methods: Between March 1995 and August 2003, 232 morbidly obese patients underwent LAGB. The pars flaccida technique was used in the majority of the patients. Data were prospectively collected. Results: The median age was 35 years and 93% were female. Initial median body weight was 129 kg with a median BMI of 46. After 5 years of follow-up, median BMI decreased to 36 and the median body weight decreased to 98 kg. Median excess weight loss was 37% after 1 year, 42% after 3 years and 42% after 5 years of follow-up. Late postoperative complications were pouch dilatation (n = 33), port revision (n = 19), erosion (n = 4) and necrosis (n = 1). Conclusion: LAGB is a safe and successful treatment for patients with morbid obesity. Maximal weight reduction is achieved within 12 months and remains stable up to at least 5 years. These results suggest that LAGB could have a positive outcome on morbid obesity-associated morbidity and overall life expectancy.

show abstract

Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding

Cited by 76 publications

References 20 publications

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Bariatric Surgery Following Treatment for Craniopharyngioma: A Systematic Review and Individual-Level Data Meta-Analysis

Surgical treatment of obesity

Outcome of 232 Morbidly Obese Patients Treated with Laparoscopic Adjustable Gastric Banding between 1995–2003

Contact Info

Product

Resources

About